Day 1 :
Ivete Contieri Ferraz
Veritas Clinic, Brazil
Keynote: The influence of environmental aesthetics in the dignity of psychiatric patient
Time : 10:00-10:40
Ferraz I C is a Medical Psychiatrist, with expertise in clinical practice, passion to improve the health and well-being of her patients. Her model of care, with an important technical foundation but open and contextual basis is quite divergent from the biomedical model. Based on the absolute protagonism of the human being, her model of care is a source of encouragement to understand the influence of multidisciplinary factors in the response to the patient's treatment, converging to a model similar to the Holistic of Health. She sediment this model in her clinical practice after 15 years of experience in hospital institutions, being currently in research, builds its theoretical foundation, seeking increasingly to understand pluralism in health and the purification of the physician-patient relationship and its therapeutic function.
Spatial aesthetics in health settings remain a challenge due to the difficulty in balancing disease prevention, such as the aseptic and ergometric protective needs of clinical hospital design, with health promotion through exposure to beauty. The objective of this work is to identify the importance of the aesthetics of the environment in the treatment of mental health, through bibliographic research of qualitative character using PubMed and SciELO databases, between the years 1996 to 2018, with the key words: Design, architecture, art, mental health, humanization, psychiatry and aesthetics. The indications of this work being that the aspects making up the design were extremely important as attributes of humanization because they produce a sense of belonging, respect and dignity in the patient, as well as the sense of control of the environment. The main variables influencing the aesthetic environment highlighted in this article are: light, sound, color, aroma, texture and shape. The design belongs to the aesthetic-artistic perspective, reinforces the protagonism of the sick human being in detriment of the disease, reinforces the expansion of the concept of care and enhances the patient's response to treatment. The conclusion reiterates that the multiaxial aspects brought about by the design of environments within hospitals, is in line with the holistic model of health, producing health promotion and positive responses to patients.
Lissa C Ramsepaul
The Catholic University of America, USA
Keynote: The changing face of youth homelessness
Time : 10:40-11:20
Lissa Ramsepaul obtained her MSW from The Catholic University of America in 2009, after completing a course of study where she received dual training in both direct practice and program development & evaluation. She holds a clinical social work license. Her PhD thesis on Risk and Resilience in formerly homeless youth, reflects her lifelong interest in working with individuals, communities, and larger systems, alleviating the impact of multifarious social issues and suffering among marginalized populations. She is passionate about blending best practices of working with underserved populations with management, advocacy, and larger systemic change. She has 22 years of hands-on experience working in the non-profit sector. Her service to vulnerable populations began with direct service delivery as a crisis counselor in the early 1990s. Today, she works as an independent consultant and has served in leadership positions for non-profit organizations to ensure that the most vulnerable clients received the highest level of care and service.
Statement of the Problem: This study seeks to examine the life experiences of homeless adults whose relationship with their parents or their children were impacted by the family’s experience of homelessness while raising children. Family systems theory identifies families as a central “system” in each society which exist for the purpose of creating and maintaining the structure and balance inside of the family system while socializing children to the norms, expectations, and internal and external factors that shape life and society (Hearn 1969). Contemporary study of family relationships improved our understanding of the long-lasting impact of the parent-child relationship as well as the role of the larger family system in creating the context in which child development occurs. A variety of individual and environmental factors impact the quality, consistency, and depth of these relationships with varying effects upon the developing child. These effects continue well into adulthood, and can provide resilience against ongoing social issues or predispose children towards risks.
Methodology & Theoretical Orientation: This is an exploratory, qualitative study that uses a grounded theory approach to understanding the lived experiences of families experiencing homelessness, and the specific impact on the relationship between parent and child.
Conclusion & Significance: The results of this study suggest the primary reason that the family become homeless is significant in contextualizing any disruption to the parent-child relationship and any impact on family cohesion. Issues of substance abuse by a parent, parental incarceration, child abuse, and domestic violence were all factors that both impacted the family’s housing stability and the parent-child relationship. This presentation will discuss the specific impact of these factors on child development and life trajectory in early adulthood, as well as potential treatment interventions.
- Psychiatry | Forensic Psychiatry | Mood Disorders | Psychosomatic Treatment | Sexual Psychiatric Disorder Anxiety and Disasters | Emergency Psychiatry
Location: Brussels, Belgium
Ivete Contieri Ferraz
Veritas Clinic, Brazil
Lissa C Ramsepaul
The Catholic University of America, USA
Cherry Gulch, USA
Title: Psychiatry reconstructed: A developmental contextual approach to resolving psychiatric symptoms
Time : 11:40-12:15
Si Steinberg, MD, is a Double Board Certified Child and Adolescent and Adult Psychiatrist who obtained his medical degree at the University of Michigan Medical School, his internship and residency training at UCLA Neuropsychiatric Institute and his Child Fellowship at Dartmouth Hitchcock Medical Center. He has been in clinical practice for the past 26 years in Idaho and Oregon, USA respectively. He is the Medical Director at Cherry Gulch a Therapeutic Boarding School in Idaho and has also served as an Adjunct Clinical Assistant Professor of Psychiatry at Pacific Northwest University of Health Sciences. His undergraduate study focused on Medical Anthropology at the University of Michigan. This helped him develop an awareness of the deep impact of psychosomatic phenomena in healing and recovery in all areas of medicine. As a result he developed a clinical practice model that aligned with the Independent Living Model of the Disability Movement: The individual; his perceptions and personal interpretations of his life experiences, takes precedence over their medicalization. He uses this model in both community mental health and private practice settings and has been teaching it to his medical and clinical staff and physician assistant, nurse practioner, and medical students as well.
Statement of the Problem: Contemporary clinical psychiatry as it is practiced today in the United States is overly focused on fast, efficient identifying, labeling (diagnosing) and medicating psychiatric symptoms. These symptoms and corresponding disorders are treated as reified medical conditions divorced from the multifaceted states of existence of the suffers who bear them. This results in high cost marginally effective medication based treatments with too frequent side effect consequences.
Methodology & Theoretical Orientation: My approach is common sense based: The way an individual perceives and understands his symptoms takes precedence during clinical interactions over fitting them into a medical model. Untangling and examining these symptoms psychotherapeutically from a developmental and trauma informed contextual perspective can heal an individual without having to resort to diagnostic labeling. If, after working in therapy to address and resolve causes and conditions, the symptoms still persist, then and only then do we utilize diagnostic labels and corresponding evidence based medical treatments.
Findings: Resolving or addressing past traumas, spiritual, relational, socioeconomic, environmental, and physical health issues often results in lasting symptom improvement or resolution. It also prevents unnecessary diagnostic labeling with corresponding prescribing of medications and associated potential adverse effects.
Conclusion & Significance: Most people upon hearing about or experiencing this approach wonder why it is not practiced more commonly than it is. Unfortunately there are many contributing factors that drive psychiatrists towards diagnosing and prescribing and away from common sense problem solving. These include pressure and advertising by pharmaceutical companies and the structure of insurance billing.
Recommendations: Reeducate and emphasize the need for our psychiatrists and residents to resolve causes and conditions underlying psychiatric symptoms prior to diagnosing and prescribing to address those symptoms.
Mercedes Hernandez Nunez Polo
A LA PAR, Spain
Title: Assessing psychological damage in people with intellectual disabilities after a traumatic event
Time : 12:15-12:50
Mercedes Hernández Nuñez-Polo work as psychologists and researchers at the Victims Support Unit for people with ID (A LA PAR Foundation) and is passionate for trauma therapy and its psychological impact on specially vulnerable populations. Mercedes additionally, accompanies and supports victims all along the judicial process guaranteeing the necessary adaptations.
Statement of the Problem: The assessment of psychological damage resulting from traumatic events is a complex process and is difficult for forensic psychologists to establish the presence or absence of a criminal act attending to the alleged victim’s psychological state. As a part of their intervention, experts must evaluate the psychological damage in order to argue the possibility that a crime has taken place and make an appropriate prospecting regarding the clinical evolution of the victims. Since there are no validated scales in Spain which evaluates traumatic symptomathology in people with intellectual disabilities (ID), The Victims Support Unity for People with ID (Madrid, Spain) is currently validating the Spanish version of what would complete a traumatic symptomathology battery assessment within this population and will afterwards analyze the type and frequency of the symptoms (anxiety, depression and PTSD) depending on the traumatic event.
Methodology & Theoretical Orientation: 120 people with ID (older18) and their main carers have been interviewed through a traumatic symptomatology battery. The inter-rater and test retest rehabilitees are being analyzed and the symptomatology frequency associated to each of the different traumatic events will be measured.
Findings: The main research hypothesis considered are, those scales under validation process which will adequately assess the symptomatology previously mentioned within Spanish population with ID. Additionally, we expect to find higher scores in PTSD (Post-traumatic stress disorder) when being victims of sexual abuse, intimidation or threats.
Conclusion & Significance: The Spanish validation of this traumatic symptomatology battery within the population with ID will be a valuable resource for forensic experts when exploring the victims’ psychological damage and will make experts decision making easier.
Maya G Liester
Palmer Ridge High School, USA
Title: Ayahuasca aka the vine of the soul as a potential new treatment for depression
Time : 12:50-13:25
Maya is a student at Palmer Ridge High School in Monument, Colorado in the USA. She is a percussionist in her school’s Wind Ensemble and plays center field for her school’s softball team. She will attend university after graduating from high school in 2019 and plans to pursue a career in medicine. She is co-author of the article: “A Review of Psychiatric Disorders Associated with Celiac Disease,” which was published in 2017, and is the lead author on a current investigation entitled: “Potential Effects of Drought on Celiac Disease.”
Introduction: Ayahuasca, a plant mixture from the Amazon rainforest, has been used by indigenous peoples for thousands of years. The brew is prepared by boiling a mixture of two or more plants for hours until only a concentrated liquid remains. The plants used most often are Banisteriopsis caapi, which contains β-carboline alkaloids with monoamine oxidase inhibitor (MAOI) properties, and Psychotria viridis, which contains the serotonin agonist N,N-dimethyltryptamine (DMT). In indigenous cultures, this medicine is utilized to facilitate healing, prophesy, and divination. More recently, the use of ayahuasca has spread to non-indigenous cultures, where it has been reported to produce rapid improvement in depression after only a single dose. We review the literature on the use of ayahuasca as a treatment for depression, examining the potential risks and benefits of this medicine, as well as potential mechanisms of action.
Methodology: We conducted a PubMed literature search using the search terms “ayahuasca” and “depression.” The final studies selected for inclusion consisted of articles that examined the effects of ayahuasca on depression.
Findings: HAM-D (Hamilton Depression Scale) and MADRS (Montgomery-Asberg Depression Rating Scale) scores decrease rapidly following a single dose of ayahuasca, and remain decreased for upto 21 days. Scores are reduced by as much as 82%. Prior reviews have found ayahuasca is well tolerated, increases introspection and positive mood, activates frontal and paralimbic regions, and decreases default mode network activity. Long-term ayahuasca use is associated with increased cortical thickness in the anterior cingulate gyrus and thinning of the posterior cingulate cortex.
Conclusions: Ayahuasca exhibits rapid antidepressant effects. Potential mechanisms of action include: biochemical, physiological, psychological, and transcendent pathways. Other potential uses of ayahuasca in the treatment of psychiatric disorders are discussed. Further research is recommended to investigate the potential benefits and risks of ayahuasca as a treatment for psychiatric disorders
Laboratory of Psychology Social and Cognitive, France
Title: A new integrative and preventive intervention program for patients undergoing hematopoietic stem cell transplant: first results of a pilot study with students
Time : 14:30-15:05
Maya Corman is currently a second year PhD student in psycho-oncology under the supervision of Professor Michaël Dambrun, Her thesis work focuses on a psychological approach of people with hemopathy and undergoing stem hematopoietic cell transplantation process. She has published many articles in reputed journals.
Background & Aim: People undergoing bone marrow transplantation may have some psychological symptoms such as depression and anxiety, and physical symptoms as pains all along the process, especially during hospitalization. An investigation about a new preventive intervention to help people to cope with this event has been led. This program is divided into three subtasks: the first one is a new attentional bias modification task, the second one is an optimizing emotional regulation task and the third one is a mindfulness intervention. Each task aims to facilitate the realization of the next one. The program would be implementable at home and during hospitalization with a digital platform. Before implantation in hospital, a pilot study was conducted in laboratory with the first subprogram.
Methodology & Theoretical Orientation: 38 students were recruited (Mage=22.6; SD=7.2, Nexperimental condition=19). This attentional bias modification task consisted in detecting a positive picture amongst three others (negatives and neutrals), moving it towards the screen’s center and savoring the associated emotion. Before and after trainings they realized an eye tracker procedure in order to detect the presence of an attentional bias modification.
Findings: The increase of positivity bias (i.e. a longer fixation time on positive stimuli) was significantly greater in the experimental condition than in the control one. There is no significant decrease in negativity bias in the experimental condition as control. The effects of the task on positivity bias tend to be greater for subjects with depressive symptoms.
Conclusion & Significance: First result of this pilot study provides interesting elements to pursue our investigations. Next step is to test effectiveness of the second intervention (a positive psychology one) with completion of the first task. Finally, we will test the whole program before proposing it to patients before and during their hospitalization.
Mataria Teaching Hospital, Egypt
Title: The comparison of personality traits, self-esteem, sexual harassment in Arabic women with and without sexual aversion and vaginismus
Time : 15:05-15:40
Atia Attaky holds an MBBCh Degree and MSc in Neuropsychiatry from Al Azhar University (Egypt). He is currently a PhD Researcher at Maastricht University (The Netherlands) and has his work focused on dyadic sexual dysfunction in Arabic couples. He is considered one of a few Arabic international experts on psychosexual medicine and neuropsychiatry with over 14 years of clinical and research experience. He has published more-reviewed scientific articles on sexuality in Arabian countries. He is considered the first Arabic Neuropsychiatrist to hold European Fellowship in Sexual Medicine (FECSM) and a Diploma in Psychosexual Therapy and Diploma in Sex Addiction (London, UK). He is an Ambassador of the American Sexual Health Association (ASHA) and a Member of- European Society for Sexual Medicine (ESSM); International Society for Sexual Medicine (ISSM) and Middle East Society for Sexual Medicine(MESSM); African Society for Sexual Medicine(ASSM) respectively.
Background: Female sexual dysfunction (FSD) is often a common problem with significant effects on women’s quality of life and leads to disturbance in a women’s ability to respond sexually or to experience sexual pleasure and has profound serious impact on a woman's self-esteem and her relationships And leads to a negative impact on the wellbeing of her spouse.
Purpose: The purpose of this study to determine personality characteristics and self-steam and sexual harassment in female with sexual aversion and vaginismus and comparing with healthy women, little studies and data has focused on this area especially in Arabian countries.
Materials & Methods: A cross-sectional research, method was adopted in the present investigation during the year 2018 between January and April including 30 married women who are 19-45 years old live in Saudi Arabia, the study population was recruited among women attending Mutmaena Medical Psychiatric Center in Riyadh city, and we selected women complaining of sexual aversion and other women vaginismus as diagnosed by DSM-IV-TR. We also compared 15 healthy women, after oral consent, all women were available face to face to complete answer Saudi version of the Eysenck Personality Questionnaire (EPQ-R) and Arabic version of the Rosenberg Self-Esteem and Sexual Harassment Experience Questionnaire (SHEQ) and to compare between three groups. Data were analyzed using IBM-SPSS version 21. Statistical significance was set at p<0.05.
Results: A total of 45 female with mean age mean age (mean±22.78±SD1.87) were studied, the most common personality dimension in female with sexual dysfunction is neuroticism- 66.67% more common in women with vaginismus than women complaining from sexual aversion- 53.33% which is significantly higher than healthy female And the study showed that sexual harassment common among 80% and highly significant in women with sexual dysfunction than healthy women at 20% and more common in women complaining from sexual aversion (significant) and unwanted sexual harassment is common in women with aversion than women suffering from vaginismus but sexual coercion is common in women with vaginismus. Low self-esteem was common among 93.33% and significant in women with sexual dysfunction than healthy women and more common in women with vaginismus
Conclusions: In this research will provide a basic knowledge especially in this area personality characteristics as neuroticism and unwanted sexual harassment, low self-esteem are significant factors.
St. Joseph’s Hospital, Syracuse, USA
Title: Case report: Use of eye movement desensitization and reprocessing (EMDR) for treatment of psychogenic non-epileptic seizures
Time : 15:40-16:15
Tarun Kumar obtained his MBBS (equivalent of MD in USA) from Kasturba Medical College of Manipal University, Mangalore, India. He completed his Residency in Psychiatry from Mount Sinai School of Medicine- Elmhurst Hospital in New York after which he pursued Child and Adolescent Psychiatry Fellowship from State University of New York (SUNY)- Upstate University, Syracuse, New York and Forensic Psychiatry Fellowship from Rutgers University, New Jersey (USA) respectively. He has published numerous articles in National and International Journals. He is also on Editorial Board for many renowned psychiatry journals. He is currently working as attending Psychiatrist in Psychiatry Emergency Room at St. Joseph Hospital in Syracuse and also serves as voluntary Faculty in the Department of Psychiatry at SUNY Upstate University.
Psychogenic non-epileptic seizures (PNES) are sudden, involuntary seizure-like episodes that, unlike epileptic seizures, do not produce electrographic ictal discharges on EEG (electroencephalogram). Symptoms can include changes in behavior, motor, sensory, cognitive and autonomic functions. Psychogenic non-epileptic seizures (PNES) is prevalent in about 20% of children and 40-58% of adults that get evaluated by primary care doctors or at epilepsy centers. It has been estimated that 300,000-400,000 people may suffer from PNES in the United States alone and despite its high prevalence; there is no clear understanding of its etiology, diagnosis, and treatment. Eye movement desensitization and reprocessing (EMDR) is a recent therapeutic modality that is commonly being used to treat patients with posttraumatic stress disorder (PTSD). In this therapy, the patient exposes self to past experiences in brief sessions while focusing on external stimulus. This therapy helps patients to reduce distressing thoughts and feelings and leads to better social functioning. Post-traumatic stress disorder (PTSD), other anxiety disorders, dissociative disorders, depression, and borderline personality disorder are comorbidities frequently encountered in PNES patients. The exact relationship between PTSD and PNES is not clearly understood but it has been hypothesized that traumatic experiences can lead to stress related neurochemical and neuro-anatomic changes leading to dysregulation of stress reactivity in susceptible individuals. This dysregulation can manifest itself in somatoform or conversion-like disorders of which PNES is one. The author will present a case of a 55 year old Caucasian male who was diagnosed with PNES and had been stable on clonazepam 2 mg TID (three times a day) for 5 years but started experiencing side effects (blurry vision) from medication. This patient was successfully treated with EMDR. He was able to taper down his clonazepam significantly without having relapse of his conversion symptoms or side effects.